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pentobarbital will reduce the extent or result of fentanyl intranasal by impacting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Keep an eye on Closely. Coadministration of fentanyl with CYP3A4 inducers may lead to a lower in fentanyl plasma concentrations, lack of efficacy or, possibly, development of a withdrawal syndrome in the aff